Da Vinci Postable Remittance
1.0.0 - STU 1 United States of America flag

This page is part of the DaVinci Postable Remittance FHIR Implementation Guide (v1.0.0: STU 1) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

: ExampleSearchPaymentResult - JSON Representation

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{
  "resourceType" : "Parameters",
  "id" : "ExampleSearchPaymentResult",
  "meta" : {
    "profile" : [
      🔗 "http://hl7.org/fhir/us/davinci-pr/StructureDefinition/searchByPaymentResultParameters"
    ]
  },
  "parameter" : [
    {
      "name" : "TIN",
      "valueString" : "123485858"
    },
    {
      "name" : "Payer",
      "part" : [
        {
          "name" : "PayerID",
          "valueString" : "52415"
        },
        {
          "name" : "PayerName",
          "valueString" : "Acme Payment Inc"
        }
      ]
    },
    {
      "name" : "PaymentInfo",
      "part" : [
        {
          "name" : "PaymentIssueDate",
          "valueDate" : "2023-11-02"
        },
        {
          "name" : "PaymentNumber",
          "valueString" : "A12385858"
        },
        {
          "name" : "PaymentAmount",
          "valueMoney" : {
            "value" : 30,
            "currency" : "USD"
          }
        },
        {
          "name" : "Remittance",
          "part" : [
            {
              "name" : "RemittanceAdviceIdentifier",
              "valueString" : "A123456BCDEF"
            },
            {
              "name" : "RemittanceAdviceType",
              "valueCode" : "application/EDI-X12"
            },
            {
              "name" : "RemittanceAdviceDate",
              "valueDate" : "2023-11-02"
            },
            {
              "name" : "RemittanceAdviceFileSize",
              "valueInteger" : 1536
            }
          ]
        }
      ]
    },
    {
      "name" : "PaymentInfo",
      "part" : [
        {
          "name" : "PaymentIssueDate",
          "valueDate" : "2023-11-03"
        },
        {
          "name" : "PaymentNumber",
          "valueString" : "A12385859"
        },
        {
          "name" : "PaymentAmount",
          "valueMoney" : {
            "value" : 30,
            "currency" : "USD"
          }
        },
        {
          "name" : "Remittance",
          "part" : [
            {
              "name" : "RemittanceAdviceIdentifier",
              "valueString" : "A123456BCDXY"
            },
            {
              "name" : "RemittanceAdviceType",
              "valueCode" : "application/EDI-X12"
            },
            {
              "name" : "RemittanceAdviceDate",
              "valueDate" : "2023-11-03"
            },
            {
              "name" : "RemittanceAdviceFileSize",
              "valueInteger" : 2048
            }
          ]
        }
      ]
    }
  ]
}